# NTSB DCA92MA040: Cessna 402C, N2715X, Meadview, AZ, June 19, 1992

- Type: NTSB accident investigation
- Classification: Accident · Fatal · Major investigation · Final report
- Date: June 19, 1992, 14:05 local (21:05 UTC)
- Place: Meadview, AZ
- Coordinates: 35.97974, -114.060173 (estimated)
- Nearby events: https://openairdocs.org/map.md?lat=35.9797&lon=-114.0602&mi=10
- Phase of flight: [Initial climb](https://openairdocs.org/ntsb-phases/350) (OpenAirDocs' grouping)
- Highest injury: Fatal
- Injuries: 10 fatal
- Status: Completed, report November 3, 1993
- Report: Approved by Office Director
- NTSB office: Major Investigations Division
- Safety recommendations: Yes
- NTSB case key (mKey): 15956
- NTSB case page: https://web.ntsb.gov/investigations/?ntsbnumber=DCA92MA040
- NTSB report (PDF, downloads): https://data.ntsb.gov/carol-repgen/api/Aviation/ReportMain/GenerateNewestReport/15956/pdf
- Page: https://openairdocs.org/ntsb/DCA92MA040

## Probable cause

FAILURE OF THE PILOT TO FOLLOW THE EMERGENCY PROCEDURE (ENGINE FAILURE AFTER TAKEOFF) AND HIS FAILURE TO MAINTAIN MINIMUM CONTROL SPEED (VMC), WHICH RESULTED IN A LOSS OF AIRCRAFT CONTROL.  FACTORS RELATED TO THE ACCIDENT WERE FAILURE (DISENGAGEMENT) OF THE RIGHT ENGINE FUEL PUMP DRIVE COUPLING, HIGH DENSITY ALTITUDE, AND THE LACK OF COMPANY TRAINING CONCERNING AIRCRAFT PERFORMANCE IN CONDITIONS OF HIGH DENSITY ALTITUDE AND HEAVY GROSS WEIGHT.

## Sequence of events

In NTSB's coding before 2008 (https://www.ntsb.gov/GILS/Documents/codman.pdf).

- Loss of engine power, takeoff - initial climb
  - fuel system,pump - failure,total (contributing factor)
- Loss of control - in flight, takeoff - initial climb
  - weather condition - high density altitude (contributing factor)
  - emergency procedure - not followed, pilot in command (cause)
  - inadequate training(emergency procedure(s)), company/operator management (contributing factor)
  - propeller feathering - not attained, pilot in command (cause)
  - airspeed(vmc) - not maintained, pilot in command (cause)
  - aircraft control - not maintained, pilot in command (cause)
- In flight collision with terrain/water, descent - uncontrolled

## Analysis

PLT BEGAN TAKEOFF ON A 5200-FT DIRT RWY (UPSLOPE TO THE SOUTH, ELEV 4775 FT) WITH WIND FROM THE SOUTH AT 18-20 KTS, DENSITY ALT ABOUT 7250 FT. WITNESSES OBSERVED THE ACFT TAKING OFF, WITH THE LANDING GEAR RETRACTING AS IT PASSED THEIR PSN. SOON THEREAFTER, THE PLT TRANSMITTED HE HAD 'A PROBLEM.' ACFT WAS THEN SEEN ABOUT 200-300 FT AGL IN RIGHT TURN, WHICH PROGRESSED INTO A DIVE. ACFT IMPACTED IN FLAT ATTITUDE 1/2 MI SOUTH OF RWY 17. PSGR VIDEO TAPES REVEALED PROPS WENT OUT OF SYNC ABOUT 6 SEC ATER TAKEOFF. ABOUT 15 SEC LATER, RIGHT PROP SLOWED UNTIL BLADES COULD BE SEEN TURNING. VIDEO SHOWED ONE ENG FUEL FLOW AT ABOUT 90 GPH, OTR ENG AT MIN SETTING (ABT 3 PSI), 5 DEG INCREASE IN PITCH ATTITUDE. EXAM REVEALED RGT ENG DRIVEN FUEL PUMP DRIVE COUPLING WAS SCORED AND ONLY PARTIALLY ENGAGED. SB ME88 3 COMPLIED WITH; AUX FUEL PUMP SWS FOUND IN LOW PSN. RGT PROP BLADES FND AT FINE PITCH, LACKING ROTATIONAL DMG. LNDG GEAR FND UP, BUT UNLOCKED; FLAPS EXTDD 15 DEG. EMERG PROC TRNG DID NOT REPLICATE HI DENSITY ALT AND MAX GROSS WEIGHT PERFORMANCE.

## Aircraft

- Registration: [N2715X](https://openairdocs.org/deregistered/N2715X-1992-11-30), registration cancelled 1992-11-30, S/N 402C0215 (OpenAirDocs)
- Reported make and model: CESSNA 402C
- Registry model: [Cessna 402C](https://openairdocs.org/model/cessna-402c) (registry code 207590R) (OpenAirDocs)
- Category: Airplane
- Serial number: 402C0215
- Airframe hours: 9266
- Engines: CONTINENTAL TSIO-520-VB 325 horsepower reciprocating
- Damage: Destroyed
- Flight: Part 135
- Operator: Adventure Airlines
- Registered owner: Adventure Airlines
- Airworthiness certificate: Standard, Normal
- Last inspection: AAIP, May 29, 1992, 50 hours before
- Departed: AZ38
- Destination: LAS, LAS VEGAS, NV
- Flight plan: Company VFR
- Airport: AZ38, Grand Canyon West, runway 17, 5,200 × 100 ft, dirt

## Flight crew

As NTSB recorded them. NTSB leaves out names.

- Pilot; age 61; flight instructor, commercial; airplane ratings: single-engine land, multi-engine land; instrument ratings: airplane; medical: class 1, valid medical--w/ waivers/lim; seat: left; toxicology performed; flight hours: 7,891 total, 2,030 in this make and model, 7,684 as pilot in command, 171 in the last 90 days, 31 in the last 30 days, 6 in the last 24 hours

## Weather

- Conditions: Visual (VMC), Day
- Wind: 170° at 18 knots
- Visibility: 35 statute miles
- Lowest ceiling: none
- Temperature: 97 °F, dew point 28 °F
- Altimeter: 29.00 inHg

## FAA reports on this event (1)

The FAA's own accident and incident reports, matched to the aircraft by N-number and date (OpenAirDocs).

- [Accident 19920619021309A](https://openairdocs.org/incident/19920619021309A), Jun 19, 1992: Cessna 402C, Meadview, AZ, Destroyed, 10 fatal. Lost power right engine on climbout lost control below IMC. Fuel pump out. Worn fuel valves. Improper procedures.

From the NTSB's public API. Aircraft are matched to registry aircraft by N-number and event date, checked against the reported serial number, make and model; the registry's history has gaps, so older matches can be wrong. Compare the reported make and model.

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